J Trauma
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The overall incidence of cervical spine injury (CSI) has been estimated from small studies; the incidence of specific injury types is less well established. The approach to screening for CSI has not been well studied; variation may exist based on Trauma Center (TC) level and type (academic vs. nonacademic). We attempted to define the incidence of different types of CSI and determine whether a national standard for cervical spine clearance (CSC) could be identified. We hypothesized a significant variation in incidence of CSI and approach to CSC based on TC level and type. ⋯ Incidence of CSI is uniform by TC level and type. Incidence of spinal cord injury without fracture is low: 0.7%. Reported rate of missed CSI is very low: 0.01%. There is good agreement (>78%) among TC on indications for CSC but less agreement on radiographic approach to CSC.
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Randomized Controlled Trial Comparative Study Clinical Trial
Internal fixation of distal radius fractures with dorsal dislocation: pi-plate or two 1/4 tube plates? A prospective randomized study.
Severely comminuted distal radius fractures can be treated by different methods. Our routine procedure in dorsal dislocated fractures is the dorsal stabilization with two 1/4 tube plates. The new pi-plate is an other device that matches optimally the anatomy of the distal radius and allows a near half-circumferential dorsal buttress of comminuted intraarticular and extra-articular radial fractures. ⋯ With open reduction, cancellous bone grafting, and internal plate fixation in comminuted distal radial fractures, excellent results can be achieved. In our experience, we cannot recommend the 7pi-plate in its current shape and prefer to stabilize distal radius fractures and dorsal fragment dislocations with two 1/4 tube plates.
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To determine the accuracy of intravenous contrast-enhanced computerized tomography (CECT) in the detection of potentially life-threatening retroperitoneal hemorrhage in patients sustaining pelvic fractures, acetabular fractures or both. ⋯ The finding of contrast extravasation on CECT is highly suggestive of significant arterial bleeding that requires early angiographic embolization to restore hemodynamic stability.